Abstract:
Currently, unpredicted rapid resurgence of malaria is happening in almost all endemic areas of
Ethiopia, after decline in the few past years. This study was thus aimed at investigating malaria
resurgence and associated risk factors, and challenges encountered in the process of
implementing the interventional activities at Bonga town, Kaffa zone, Southwest Ethiopia.
Health facility-based retrospective and cross-sectional study design was employed. Data was
analyzed using SPSS software version 26. Multiple linear and logistic regression models utilized.
Qualitative data was thematically analyzed. The finding of the present cross-sectional study
revealed that the current malaria positivity rate (from January to May, 2024) in the study area
was 50.72% (315/621). The study identified a resurgence of malaria was linked to weakened
control measures (p=0.006), limited awareness of the population (p<001), and socio
demographic factors such as education (p=0.037), housing condition (p<0.0001), low income
level (p<001), and travel history to malaria endemic areas (p=0.001)] and weakened health
care system. The findings of retrospective analysis also showed an increasing malaria positivity
trend between 2010 and 2023, where the overall 30.18% (19,582/64, 885) malaria positivity
rate. Plasmodium falciparum was the dominant malaria parasite 12,730 (19.62%). Age >14
years (p=0.008), male patients (p=0.018), year increment from 2010 to 2023 (p=0.013), and
some months: September to November was strongly and positively associated with malaria
positivity in the area. On the other hand, statistically significant negative association between
intervention activities and malaria positivity rate was observed. As ITNs distribution increased
by 1-unit, malaria positivity rate was decreased by 0.533 (p=0.001). Similarly, as IRS activity
increased by 1-unit, malaria positivity rate was decreased by 0.781 (p=0.004). Although
Ethiopia was aggressively working on the malaria control activities in the past years, the recent
interruption of implementing interventional activities (distribution of ITN and IRS) could
contributed for the observed high malaria positivity rate. In addition, the limited knowledge and
awareness of patients observed on the malaria infection calls the need for immediate community
sensitization activities, besides designing integrated interventional strategies to tackle the
current terrible situation.
